11237 research outputs found
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Pedagogical innovation and educator wellbeing in UK audiology teaching: cross-institutional insights from the COVID-19 experience
No full textBackground: Academic teaching staff in higher education routinely balance multiple roles, including teaching, research, and pastoral student care. The onset of the COVID-19 pandemic, which forced the closure of university campuses, significantly intensified these demands. To maintain the continuity and quality of education, staff were required to swiftly adapt and implement new, robust teaching methods. This sudden shift placed additional pressure on an already stretched workforce. This study aims to investigate the impact of the COVID-19 pandemic on audiology education in the United Kingdom (UK), with a particular focus on the work-related wellbeing of academic teaching staff.
Methods: A qualitative study was conducted using semi-structured interviews with eleven teaching staff involved in audiology higher education across the UK.
Results: The following four themes were identified (1) initial institutional response to the pandemic, (2) adapting practical audiology training through teleaudiology and patient simulation, (3) supporting students whilst safeguarding staff wellbeing, and (4) pedagogical approaches for a unique, technology-driven audiology profession.
Conclusion: The detrimental impact of the pandemic on academic staff well-being was evident in the form of increased workloads and escalating institutional pressures, which frequently prioritized student well-being over that of staff. Audiology HEI educators acknowledged that while audiology training cannot be entirely conducted online due to the essential hands-on skills that must be practiced in person, a hybrid or blended learning approach could be beneficial.</p
Music-based interventions in the treatment of eating disorders: a scoping review
No full textIntroduction: Eating disorders (EDs) are potentially life-threatening conditions characterized by persistent eating- and body-related disturbances that negatively impact nutritional intake, psychological well-being, and physical health. While psychological therapies remain the primary treatment for patients with EDs, music-based interventions (MBIs) show significant promise for addressing symptoms in clinical practice. However, little is known about the methods employed in these interventions or their effectiveness in addressing or improving ED outcomes.Methods: Following PRISMA-ScR guidelines, we conducted a scoping review of the literature. Eight electronic databases were systematically queried from inception to May 2025 for studies evaluating MBIs in patients engaged in ED treatment. Data regarding study design, sample characteristics, intervention components, and primary outcomes were extracted and analysed utilising either reflexive thematic analysis or descriptive statistics. The quality of intervention reporting was additionally examined utilising the established MBI reporting guidelines.Results: Of the 114 articles screened, 21 met inclusion criteria. The final sample comprised 10 case studies, 6 qualitative studies, 4 quantitative studies, and 1 mixed methods study, with all but one conducted in high-income countries. Settings included inpatient (n = 12), outpatient (n = 7), and combined (n = 2) ED programs. Most MBIs involved music therapy (n = 18), while others incorporated vibroacoustic therapy (n = 1), background music during mealtimes (n = 1), and group singing (n = 1). Delivery formats encompassed individual (n = 14), group (n = 5), and hybrid (n = 1) sessions, or were not indicated. Qualitative synthesis identified seven themes reflecting symptom management, self-development, and treatment engagement. Quantitative studies reported improvements in anxiety, mood, ED symptoms and increased food eaten and weight gain. However, robust conclusions were limited by small sample sizes, a lack of control group, non-randomisation, or another intervention being implemented with the MBI. Overall, reporting of MBI components was inconsistent, with a mean completeness of 45–100%.Discussion: To our knowledge, this is the largest scoping review to map the breadth and depth of studies assessing MBIs in ED treatment. Preliminary evidence supports positive psychological and behavioural outcomes for patients with EDs. However, conclusions are limited by lack of methodological rigor, variable outcome measures, and inconsistent reporting of intervention components or theoretical framework. The complex and multifaceted nature of EDs and high rates of comorbidities and trauma histories further complicates interpretations. To advance research and clinical application of MBIs in ED care, standardized approaches to intervention design and reporting are needed, as well as randomised controlled studies clearly testing MBIs against other interventions.</p
Invasive Physiological Assessment of Lower Limb Peripheral Arterial Disease: A Narrative Review
No full textPeripheral arterial disease (PAD) affects over 236 million people globally, with endovascular treatment as the predominant mode of revascularization. While pre-procedural lesion assessment typically relies on non-invasive Doppler measurement, invasive physiological assessment offers a promising approach to guide lesion selection and provide real-time evaluation of angioplasty success. This review explores the current methods, challenges, and future directions of invasive physiological assessment in PAD. Sensor-tipped wires, particularly pressure sensor-tipped wires (pressure-wires), enable precise evaluation of stenoses through indices such as peripheral fractional flow reserve (pFFR) measured during hyperaemia. pFFR can identify significant flow-limiting lesions, assess angioplasty efficacy, and predict tissue healing. Additional indices, including Doppler-wire derived flow reserves and resistance measurements, further enhance the understanding of lesion physiology. Early data support the utility of these techniques for guiding treatment decisions, although the variability in methodologies highlights the need for standardization and outcome-driven cut-off values. This review uniquely consolidates evidence on invasive physiological assessment in PAD, addressing critical gaps and providing a framework for future research. By advancing lesion-specific evaluation and procedural optimization, this work underscores the transformative potential of these techniques in improving patient outcomes and redefining PAD management.</p
Exploring the role of natural capital and biodiversity risks and opportunities in corporate decision-making
No full textThis thesis tests the hypothesis that companies do not treat biodiversity and natural capital as material to their business due to an absence of policy and non-policy drivers, which is contributing to the environmental crisis and creating long-term risks to both society and themselves. Relatively little business management theory addresses companies’ interactions with nature, with previous research focused on quantitative assessments of specific activities rather than taking a strategic view. This thesis uses a mixed methods approach to address these gaps testing: 1. if companies perceive natural capital risks as material; 2. the drivers and barriers that affect the way they act; and 3. potential levers that could be deployed to bridge this ‘materiality gap’.It uses content analysis to assess how the world’s largest companies disclose their interactions with nature. Combining different management theories – stakeholder theory, legitimacy theory and Hart’s (1995) Natural-Resource-Based View of the firm – it finds very few companies take comprehensive action, suggesting most do not consider it a material issue, treating it more as a form of impression management. Using correlation analysis, it finds that whilst most companies have not yet embarked on their nature positive journeys, those that take a broader view of materiality are likely to take more comprehensive action.Thematic analysis is used to combine inputs from an expert workshop with documentary analysis and company interviews, to identify and rank different barriers and drivers in a PESTLE framework. These barriers are tested against companies’ performance, finding a relationship between economic, legal and political drivers, but that a company’s industry sector is less of a driver of its performance.Findings from an expert workshop and documentary analysis are combined to create two future nature scenarios (‘Best-Case’ and ‘Middle-of-the-Road’) and a series of descriptive indicators. Using a back-casting approach to explore the path to a nature positive future, it finds that no single lever would drive change by itself with many depending on the introduction of others, and that fundamental changes to the socio-economic structure are required, reinforced by institutional reform and backed by strong leadership that implements coordinated long-term decisions.The thesis identifies that the current suite of management theories provides an inadequate platform to address external systemic risks posed by natural capital degradation. It presents the concept of Beyond Stakeholder theory, extending traditional stakeholder theory to introduce a recognition that the company and its associated stakeholders operate within and are therefore restricted by the confines of the natural world.</p
Association between unclean cooking fuel use and hearing problems among adults aged ≥65 years, a cross-sectional study
No full textBackground and Aims: Literature suggests that outdoor air pollutant exposure is associated with hearing problems, but examination of this link has not extended to any potential association between hearing ability and the use of unclean cooking fuels. The current paper investigates whether such a link exists, utilizing a large sample of older adults from low- and middle-income countries (LMICs) where such fuels are commonly used.Methods: Data from the Study on global AGEing and adult health (SAGE) were analyzed. This is a nationally representative and cross-sectional data set collected for the World Health Organization for residents of South Africa, China, Ghana, India, Mexico, and Russia. A range of “unclean” cooking fuels were assessed, namely agriculture or crop, animal dung, coal or charcoal, Kerosene or paraffin, shrubs or grass, and wood. Hearing problems referred to the interviewer-rated presence of this condition. Statistical analysis was done using multivariable logistic regression.Results: The present work analyzed data from 14,585 individuals aged ≥ 65 years [mean (SD) age 72.6 (11.5) years; 55.0% females]. In the overall sample and in the final adjusted model, unclean cooking fuel use was associated with a significantly increased risk of hearing problems (OR = 1.68 (95% CI = 1.22–2.30). This association was significant for females (OR = 2.36; 95% CI = 1.53–3.63) but not for males (OR = 1.20; 95% CI = 0.79–1.81).Conclusion: Unclean cooking fuel use is associated with an increased risk of hearing problems among adult residents of LMICs over 65 years of age, particularly among females. Findings from this study support the development of Sustainable Development Goal 7 (United Nations), which advocates for fairer and more sustainable access to modern energy, as well as a means to prevent avoidable hearing problems.</p
An Exploration of Inclusion Health Teaching in the Undergraduate Medical Curricula - how appropriate for practice is the ‘inclusion health’ training received by medical students and what do advocates for inclusion health communities’ suggest should be included in the curricula to enhance service delivery.
No full textInclusion health—addressing the needs of marginalised
and minoritised communities—remains an
underdeveloped area within UK medical education. While awareness of the impact of social determinants on health
outcomes is growing, gaps in training and professional knowledge persist, limiting effective engagement in community settings. Empirical literature remains sparse,
though civil society and practitioner-led resources are
emerging¹. A 2022 Queen’s Nursing Institute (QNI) evaluation² highlighted the need for faculty development
and co-designed curricula to better prepare professionals
to work with excluded populations and enhance workforce
employability in this field. Despite increased attention to
race, intersectionality, and structural exclusion, the extent
to which inclusion health is embedded in medical curricula
remains unclear.</p
Acceptability of a digital pulmonary rehabilitation app as an adjunct or alternative to usual care for people with chronic lung diseases: A qualitative study of patients’ views and experiences
No full textBackground
Centre-PR may not be accessible for people living distant from PR centres. Remote digital PR may have equivalent benefits to centre-PR; however, previous trials were potentially biased towards digitally literate patients, and largely excluded participants with a preference for centre-PR. There is limited data on the real-world implementation of, and acceptability for, Digital-PR alone or as an adjunct to other models of PR.
Objectives
To gather patients’ views about the acceptability of Active+me REMOTE, a digital pulmonary rehabilitation app (Digital-PR).
Methods
A qualitative exploratory study using semi-structured interviews with a subset (n = 15) of patients in a mixed method, feasibility study of a hybrid pulmonary rehabilitation, blending Digital-PR with other models of PR. Transcribed data were coded descriptively using Braun and Clarkes’ methodology, data interpretation was facilitated through a Miro virtual whiteboard.
Results
There was appreciation for the concept of Digital-PR, indicated by positive responses in the domains of “friends and family recommendation,” “intention to continue using the app,” and “privacy concerns.” Benefits were reported by two participants who had declined centre-based PR. The app was rated low regarding user-friendliness. Challenges in understanding/using the app and a perception of challenges for others were reported and were associated with poor digital literacy and tech savviness. High digital skills did not predict a favourable assessment of the app as user-friendly.
Discussion
Whilst there was a general appreciation for the concept of digital PR as an adjunct or alternative to traditional centre-based PR, the app did not appear to be user-friendly, nor acceptable to people with low digital literacy. The findings have implications for the wider routine implementation of Digital-PR.</p
The Effect of Girth Design and Girth Tension on Saddle-Horse Pressures and Forelimb Stride Kinematics in Rising Trot
No full textThe aim of this study was to investigate the effect of girth design and girth tension; six horses regularly ridden were used. Each horse underwent four experimental sessions in an unbalanced Latin-square design with two girth tensions (8 kg or 16 kg) and two girth designs (straight girth (S) or anatomical girth (A)). Pressure between the saddle and the horse was measured at 100 Hz with a pressure mat (0.5 sensels per cm2). Notably, 2D limb kinematics were determined from anatomical markers placed on the fore and hindlimbs. Video was collected at 240 fps. There was no significant effect of girth type, girth tension, or girth type*tension interaction for any of the measured variables, with the exception of carpal flexion, which was significantly greater for A8 (median: 103°, 25th–75th percentile: 100–112°) than S8 (101°, 96–106°; p = 0.043). There was no effect of girth type (A or S) on mean saddle pressure for either cranial or caudal regions (p > 0.05), but caudal average pressure was significantly lower than cranial average pressure both at 8 and 16 kg tensions (p </p
Bridging the Language Divide in UK Paramedic Care: An Atomic Article Reviewing Challenges, Strategies, and Emerging Innovations
No full textThis review synthesises evidence on how language barriers impact UK paramedic care, leading to reduced on-scene assessment times, delays in treatment, and potential errors in clinical decision-making. Paramedics often rely on strategies such as body language, basic keywords, and ad hoc interpreters, which may compromise care quality. Research highlights the need for professional interpretation services and digital communication tools to support accurate, equitable patient assessment and treatment. Emerging technologies, including translation apps, show promise but require further evaluation. Addressing language barriers is essential to ensuring fair, high-quality prehospital care for patients with limited English proficiency in the UK.</p
Multi-level factors associated with the sedentary behavior of adults with intellectual disabilities in community living arrangements
No full textBackgroundSedentary Behavior (SB) is an independent risk factor for cardiometabolic diseases and mortality. Adults with intellectual disabilities (ID) that live in Community Living Arrangements (CLAs) participate in higher SB, however the factors associated with SB are unknown in this group.ObjectiveThe cross-sectional study investigated the multi-level determinants related to SB among adults with ID in community living arrangements (CLAs).MethodsAdults with ID who lived in CLAs wore an activPAL device for seven days so that SB could be estimated. Prolonged SB and total SB duration served as the outcome variables. Electronic surveys assessed factors across the levels of the social-ecological model. Bivariate analyses estimated the association between each of the independent variables with each of the SB outcomes followed by a multivariable analysis using Least Absolute Shrinkage and Selection Operator (LASSO) regressions for both prolonged SB and total SB duration.ResultsStudy participants (n = 36) had a mean age of 44.1 years (SD = 15.01), were predominantly male (58.33 %) and White (83.33 %). Nearly half (n = 16; 47.22 %) exhibited prolonged SB, spending on average 7.46 h (SD = 2.23) in SB daily. The LASSO regression identified higher independence in activities of daily living (ADL) and low levels of staff conflict as being associated with lower total SB duration and less likelihood of prolonged SB.ConclusionOur findings underscore the influence of multi-level factors on SB in adults with ID. These data suggest that interventions to reduce SB should consider not just individual traits but also the broader social and environmental contexts.</p
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